Individual
TRACY NOGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
7243 DELLA DR STE 1, ORLANDO, FL 32819-5104
(321) 843-5851
Mailing address
7243 DELLA DR STE 1, ORLANDO, FL 32819-5104
(321) 843-5851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101025655
MI
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
OS15631
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119732000
—
FL
Enumeration date
05/11/2017
Last updated
09/25/2023
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